About Covid-19
CDC approves Moderna and J&J Covid vaccine boosters, allowing people to mix-and-match shots: The headline is the story. The approval comes on the heals of the FDA’s recommendation for the same measures.
Covid Live Updates: Pfizer and BioNTech Says Vaccine Is Highly Protective in 5- to 11-Year-Olds: “Pfizer reported data on Friday showing that its coronavirus vaccine had a 90.7 percent efficacy rate in preventing symptomatic Covid-19 in a clinical trial of children ages 5 to 11.
The company submitted the information to the Food and Drug Administration, which was expected to release its own analysis of the data later in the day.
Children in the trial received a dose of 10 micrograms, smaller than the 30-microgram dose given to adults. The company said that the dosage was safe, and that trial participants had seen only mild side effects.”
BNT162b2 [Pfizer–BioNTech] and ChAdOx1 nCoV-19 [AstraZeneca]Vaccine Effectiveness against Death from the Delta Variant: “In summary, we found that the BNT162b2 and ChAdOx1 nCoV-19 vaccines offered substantial protection against death from Covid-19 caused by the delta variant.”
In a related article: Delta variant subtype detected in the US:
Association Between COVID-19 Relief Funds and Hospital Characteristics in the US: “In this cross-sectional study among 952 hospital-level entities, wide ranges existed in CARES Act funding, with 24% of hospitals receiving less than $5 million in funding and 8% receiving more than $50 million. Academic-affiliated hospitals with higher pre–COVID-19 assets and hospitals that had higher COVID-19 cases received higher levels of funding, while critical access hospitals received lower levels of financial assistance.
CARES Act funds may have disproportionately gone to hospitals that were in a stronger financial situation prior to the pandemic compared with those that were not, but funds also went disproportionately to those that eventually had the most cases.”
About pharma
Continuous Manufacturing of Pharmaceuticals Bill Clears House: “The House of Representatives passed a bill in a bipartisan 368-56 vote this week that aims to promote innovation in continuous manufacturing, which is used to produce drugs more efficiently than the conventional batch production process.
The National Centers of Excellence in Advanced and Continuous Pharmaceutical Manufacturing Act would allocate $100 million in funding from fiscal 2022 to 2026.”
Another purpose of the bill is to reduce reliance on foreign suppliers.
Vertex’s Stem-Cell Therapy Slashed Need for Daily Insulin Infusion: “Vertex Pharmaceuticals said a patient with a 40-year history of Type 1 diabetes experienced a 91 percent reduction in daily insulin dose after an infusion of its VX-880 stem-cell-derived islet cell replacement therapy.
The cells quickly began functioning as normal islet cells. And with this positive news in hand, the company will continue its phase 1/2 program at several sites in the U.S. and Canada, with the goal of submitting an Investigational New Drug application to the FDA in 2022.”
About health insurance
Next Generation Accountable Care Organization (NGACO) Model Evaluation: “As of the fourth performance year, the Next Generation Accountable Care Organization (NGACO) model was associated with $667 million in gross savings in Medicare Parts A and B spending. After factoring in $909 million in shared savings and other payouts to NGACOs, however, the model was associated with $243 million in net losses. On average, NGACOs located in markets with higher per capita Medicare Parts A and B expenditures achieved higher spending reductions, as they had greater opportunities to improve efficiency. Some NGACOs operating in markets with lower Medicare expenditures had pathways to spending reductions. The amount of total spending reductions by NGACOs of differing organizational affiliation were similar, but there were notable differences in the care settings where reductions occurred. NGACOs primarily reduced spending in settings other than their own organizational setting. Physician practice- affiliated NGACOs reduced acute care spending, but did not reduce spending for professional services. By contrast, NGACOs affiliated with hospitals or integrated delivery systems (IDS) reduced spending for professional services.”
Tennessee may have to repay more than $767 million in Medicaid funds: “Tennessee could be forced to repay the federal government $767.5 million in Medicaid funds that auditors said TennCare officials incorrectly claimed between 2009 and 2014, according to a U.S. Health and Human Services inspector general report released Thursday.
The report found that Tennessee did not comply with federal requirements for certain expenses that are supposed to be certified for eligibility for matching federal funds from Medicaid.”
Anthem BCBS, Kroger partner on health plans: “Anthem Blue Cross and Blue Shield is partnering with Kroger Health on Medicare Advantage plans that provide members with in-store benefits at Kroger locations.
The two plans — one HMO dual-eligible special needs plan and one PPO — provide members with a Healthy Groceries Card that gives them $75 a month to use at Kroger, according to an Oct. 21 news release.
Plans also include a quarterly over-the-counter product allowance and access to Kroger's 2,200 pharmacy locations. It also includes a Healthy Pantry benefit that gives members access to 12 monthly meetings with a Kroger Health dietician and delivers monthly healthy pantry staples to their door.”
BMA: Medicare Advantage Offers Lower Costs, Better Benefits Than FFS: “Medicare Advantage plans offer members additional benefits and require less spending from the federal government compared to fee-for-service (FFS) Medicare, according to a report commissioned by Better Medicare Alliance’s Center for Innovation in Medicare Advantage.
The management consulting company Milliman conducted the report by analyzing FFS Medicare and Medicare Advantage cost, enrollment, and benefit data from CMS records.
Milliman found that the federal government spends $949 per person per month on FFS Medicare, including administration costs. Meanwhile, the government spends a total of $943 per person per month on Medicare Advantage, which includes $110 in administration costs and $123 in additional benefits.
On a yearly basis, Medicare Advantage provides $32.5 billion in additional benefits while also offering beneficiaries lower out-of-pocket costs compared to FFS Medicare. Unlike FFS Medicare, Medicare Advantage plans feature an out-of-pocket spending limit.”
CMS Launches Webpage to Share Innovative State Actions to Expand Medicaid Home and Community-based Services: The “Centers for Medicare & Medicaid Services (CMS) launched a new ‘one-stop shop’ for state Medicaid agencies and stakeholders on Medicaid.gov to advance transparency and innovation for home and community-based services…Through this new webpage, state Medicaid agencies and stakeholders can access information about states' plans to enhance, expand, and strengthen home and community-based services across the country using new Medicaid funding made available by the American Rescue Plan Act of 2021 (ARP).”
UnitedHealth to repay providers shortchanged for COVID vaccine administration: “UnitedHealth Group has committed to reprocessing all of its commercial claims related to COVID-19 vaccine administration, after federal investigators confirmed the nation's largest insurer paid "millions" of providers 40% less than the Medicare rate for inoculating patients.”
Iowa privatizing Medicaid resulted in 891% more illegal care denials, report finds: “A report from Rob Sand, Iowa's auditor of state, found that privatizing the state's Medicaid program in 2016 resulted in an 891 percent increase in patients who were allegedly illegally denied care.
According to the Oct. 20 report, the transition from a Human Services Department-administered program to a managed care system, called IA Health Link, has resulted in a significant shift in Medicaid members appealing a reduction or denial of care.”
Hospitals and health systems
Ascension, AdventHealth to Unwind AMITA Health Partnership: “After working closely together for nearly seven years, AdventHealth and Ascension have decided to unwind their AMITA Health partnership, the joint operating company serving the healthcare needs of residents of the greater Chicago area.
Leaders of both sponsoring organizations have determined that going forward separately is in their collective best interest in order to more nimbly meet the changing needs and expectations of consumers in the rapidly evolving healthcare environment.”
No further information is available about the breakup.
HCA's profit more than triples to $2.3B in Q3: “Nashville, Tenn.-based HCA Healthcare saw strong growth in revenue and profit in the third quarter of 2021 compared to the same period last year.
The 183-hospital system posted revenue of $15.3 billion in the quarter ended Sept. 30, up 14.8 percent from the $13.3 billion recorded in the third quarter of 2020.
Oak Street Health Acquires Virtual Specialty Care Provider RubiconMD: Oak Street Health, Inc. ( a network of value-based primary care centers for adults on Medicare), today announced it has acquired RubiconMD, the leading technology platform providing access to specialist expertise. The deal enables Oak Street Health to integrate virtual specialty care into its existing care model, which significantly streamlines the referral process and better manages costs, enhances patient experience, and provides comprehensive care far beyond traditional primary care.
RubiconMD’s specialist network of over 230 specialists covers all major specialties, including Cardiology, Nephrology and Pulmonology. RubiconMD provides clinical insights from specialists on specific patient cases, enabling primary care providers to directly manage and coordinate more of a patient’s care needs.”
About healthcare IT
Frequent but fragmented: use of note templates to document outpatient visits at an academic health center: “Templates were used to document 89% of visits, with a median of 2 used per visit. Only 17% of the 100 230 unique templates were ever used by more than one person and most providers had their own full-note templates. These findings suggest template use is frequent but fragmented, complicating template revision and maintenance. Reframing template use as a form of computer programming suggests ways to maintain the benefits of personalization while leveraging standardization to reduce documentation burden.”
FCC awards $40M more in telehealth funding to 71 providers: “The program funds telehealth projects developed by providers across the U.S. This round of funding follows the FCC's $41.1 million disbursement to 72 providers in September. The FCC has committed grants to providers in every state, territory and Washington, D.C.” See the article for a list of grantees.
23andMe buys telemedicine specialist Lemonaid Health: “23andMe Holding Co. said Friday it agreed to pay $400 million for Lemonaid Health Inc., the on-demand platform for accessing medical care and pharmacy services, in a bid to add telemedicine and prescription drug delivery services… 23andMe CEO Anne Wojcicki said the company will combine its business of providing genetic profiles of consumers with giving patients and healthcare providers better information about health risks and treatments."
11 states ink data breach reporting laws after slew of ransomware attacks: The article has details for each of the states.